Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204E00000X | Oral & Maxillofacial Surgeon | G1-0001346 | DE |
NPI | 1427336304 |
---|---|
Provider Name | Dr. Steven Andrew Fontana |
First Address | Wilmington, DE 19806-4266 |
Second Address | Wilmington, DE 19806-4266 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2011 |
Last Update Date | 07/12/2015 |